Lindskog Jakob, Piussi Ramana, Simonson Rebecca, Högberg Johan, Samuelsson Kristian, Thomeé Roland, Sundemo David, Hamrin Senorski Eric
Sportrehab Sports Medicine Clinic, Stampgatan 14, Gothenburg, SE-411 01, Sweden.
Unit of Physiotherapy, Department of Health and Rehabilitation, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Box 455, Gothenburg, SE-405 30, Sweden.
BMC Sports Sci Med Rehabil. 2023 Aug 12;15(1):100. doi: 10.1186/s13102-023-00707-2.
Generalised joint hypermobility (GJH) has been associated with an increased risk of suffering an anterior cruciate ligament (ACL) injury. Patients with GJH exhibit lower muscle strength and poorer scores for patient-reported outcomes after ACL reconstruction, compared with patients without GJH. The aim of this study was to examine differences in the percentages of patients who return to sport (RTS) or pre-injury level of activity (RTP), muscle function and patient-reported outcomes at the time of RTS or RTP, as well as the time of RTS or RTP in patients with GJH compared with patients without GJH in the first two years after ACL reconstruction.
This prospective study used data from an ACL- and rehabilitation-specific register located in Gothenburg, Sweden. Patients aged between 16 and 50, who had a primary ACL injury treated with reconstruction, were included. Data up to two years after ACL reconstruction were used and consisted of achieving RTS and RTP, results from isokinetic muscle function tests for knee extension and flexion and patient-reported outcomes (Knee Self-Efficacy Scale, Knee injury and Osteoarthritis Outcome Score and ACL-Return to Sport after Injury scale) at the time of RTS, as well as the time of RTP. A Beighton Score of ≥ 5/9 was used to define GJH. A Tegner Activity Scale of ≥ 6 was used to define RTS, while a Tegner equal to or above pre-injury level was used to define RTP.
A total of 1,198 patients (54.7% women) with a mean age of 28.5 ± 8.6 years were included. A smaller proportion of patients with GJH achieved RTS compared with patients without GJH (49.2% vs. 57.3%, Odds ratio: 0.720, p = 0.041). Furthermore, patients with GJH were marginally less symmetrical on the knee extension strength test, expressed as a Limb Symmetry Index, at the time of RTP compared with patients without GJH (87.3 ± 13.5 vs. 91.7 ± 14.3, Cohen's d = 0.142, p = 0.022). No further differences were found between groups regarding any muscle function tests or patient-reported outcomes.
A smaller proportion of patients with GJH achieved RTS compared with patients without GJH. Patients with GJH displayed less symmetrical knee extension strength at the time of RTP compared with patients without GJH.
全身关节过度活动（GJH）与前交叉韧带（ACL）损伤风险增加有关。与无GJH的患者相比，GJH患者在ACL重建后肌肉力量较低，患者报告结局评分较差。本研究的目的是比较GJH患者与无GJH患者在ACL重建后两年内恢复运动（RTS）或恢复到伤前活动水平（RTP）的患者百分比、肌肉功能和患者报告结局，以及RTS或RTP的时间。
这项前瞻性研究使用了来自瑞典哥德堡一个特定于ACL和康复的登记处的数据。纳入年龄在16至50岁之间、因原发性ACL损伤接受重建治疗的患者。使用ACL重建后两年内的数据，包括实现RTS和RTP、RTS时膝关节屈伸等速肌肉功能测试结果以及患者报告结局（膝关节自我效能量表、膝关节损伤和骨关节炎结局评分以及ACL损伤后恢复运动量表），以及RTP的时间。采用Beighton评分≥5/9来定义GJH。采用Tegner活动量表≥6来定义RTS，而Tegner等于或高于伤前水平来定义RTP。
共纳入1198例患者（54.7%为女性），平均年龄28.5±8.6岁。与无GJH的患者相比，GJH患者实现RTS的比例较小（49.2%对57.3%，优势比：0.720，p = 0.041）。此外，与无GJH的患者相比，GJH患者在RTP时膝关节伸展力量测试的对称性略低，用肢体对称指数表示（87.3±13.5对91.7±14.3，Cohen's d = 0.142，p = 0.022）。在任何肌肉功能测试或患者报告结局方面，两组之间未发现进一步差异。
与无GJH的患者相比，GJH患者实现RTS的比例较小。与无GJH的患者相比，GJH患者在RTP时膝关节伸展力量的对称性较低。
